Flavonoid intake and its association with atrial fibrillation

Nicola P Bondonno; Kevin Murray; Catherine P Bondonno; Joshua R Lewis; Kevin D Croft; Cecilie Kyrø; Gunnar Gislason; Anne Tjønneland; Augustin Scalbert; Aedín Cassidy; Jonathan P Piccini; Kim Overvad; Jonathan M Hodgson; Frederik Dalgaard

doi:10.1016/j.clnu.2020.04.025

Flavonoid intake and its association with atrial fibrillation

Nicola P Bondonno, Kevin Murray, Catherine P Bondonno, Joshua R Lewis, Kevin D Croft, Cecilie Kyrø, Gunnar Gislason, Anne Tjønneland, Augustin Scalbert, Aedín Cassidy, Jonathan P Piccini, Kim Overvad, Jonathan M Hodgson, Frederik Dalgaard

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

BACKGROUND & AIMS: Primary prevention of atrial fibrillation (AF) through behavioural and dietary modification is a critically important and unmet need. Flavonoids are bioactive dietary compounds with promising cardiovascular health benefits. Our aim was to investigate the association between flavonoid intake and clinically apparent AF.

METHODS: Baseline data from 55 613 participants of the Danish Diet, Cancer and Health Study, without AF, recruited between 1993 and 1997, were cross-linked with Danish nationwide registries. Total flavonoid and flavonoid subclass intakes were calculated from validated food frequency questionnaires using the Phenol-Explorer database. Associations between flavonoid intake and incident AF (first-time hospitalization or outpatient visit) were examined using restricted cubic splines based on Cox proportional hazards models.

RESULTS: During a median [IQR] follow-up of 21 [18-22] years, 7291 participants were diagnosed with AF. Total flavonoid intake was not statistically significantly associated with risk of incident AF in the whole cohort. However, compared to the lowest quintile, a total flavonoid intake of 1000 mg/day was associated with a lower risk of AF in smokers [0.86 (0.77, 0.96)] but not in non-smokers [0.96 (0.88, 1.06)], and a lower risk of AF in high alcohol consumers [>20 g/d: 0.84 (0.75, 0.95)] but not in low-to-moderate alcohol consumers [<20 g/d: 0.97 (0.89, 1.07)].

CONCLUSION: Intake of flavonoids was not significantly associated with a lower risk of incident AF. However, higher intakes of flavonoids may be beneficial for those at a higher risk of developing AF.

Original language	English
Journal	Clinical Nutrition
Volume	39
Issue number	12
Pages (from-to)	3821-3828
Number of pages	8
ISSN	0261-5614
DOIs	https://doi.org/10.1016/j.clnu.2020.04.025
Publication status	Published - Dec 2020

Keywords

Atrial fibrillation
Cardiovascular disease
Flavonoids
Nutrition
Primary prevention
Prospective cohort study

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10.1016/j.clnu.2020.04.025

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Bondonno, N. P., Murray, K., Bondonno, C. P., Lewis, J. R., Croft, K. D., Kyrø, C., Gislason, G., Tjønneland, A., Scalbert, A., Cassidy, A., Piccini, J. P., Overvad, K., Hodgson, J. M., & Dalgaard, F. (2020). Flavonoid intake and its association with atrial fibrillation. Clinical Nutrition, 39(12), 3821-3828. Advance online publication. https://doi.org/10.1016/j.clnu.2020.04.025

@article{2f9d3fe9ae5e4be58740a75838c4ecec,

title = "Flavonoid intake and its association with atrial fibrillation",

abstract = "BACKGROUND & AIMS: Primary prevention of atrial fibrillation (AF) through behavioural and dietary modification is a critically important and unmet need. Flavonoids are bioactive dietary compounds with promising cardiovascular health benefits. Our aim was to investigate the association between flavonoid intake and clinically apparent AF.METHODS: Baseline data from 55 613 participants of the Danish Diet, Cancer and Health Study, without AF, recruited between 1993 and 1997, were cross-linked with Danish nationwide registries. Total flavonoid and flavonoid subclass intakes were calculated from validated food frequency questionnaires using the Phenol-Explorer database. Associations between flavonoid intake and incident AF (first-time hospitalization or outpatient visit) were examined using restricted cubic splines based on Cox proportional hazards models.RESULTS: During a median [IQR] follow-up of 21 [18-22] years, 7291 participants were diagnosed with AF. Total flavonoid intake was not statistically significantly associated with risk of incident AF in the whole cohort. However, compared to the lowest quintile, a total flavonoid intake of 1000 mg/day was associated with a lower risk of AF in smokers [0.86 (0.77, 0.96)] but not in non-smokers [0.96 (0.88, 1.06)], and a lower risk of AF in high alcohol consumers [>20 g/d: 0.84 (0.75, 0.95)] but not in low-to-moderate alcohol consumers [<20 g/d: 0.97 (0.89, 1.07)].CONCLUSION: Intake of flavonoids was not significantly associated with a lower risk of incident AF. However, higher intakes of flavonoids may be beneficial for those at a higher risk of developing AF.",

keywords = "Atrial fibrillation, Cardiovascular disease, Flavonoids, Nutrition, Primary prevention, Prospective cohort study",

author = "Bondonno, {Nicola P} and Kevin Murray and Bondonno, {Catherine P} and Lewis, {Joshua R} and Croft, {Kevin D} and Cecilie Kyr{\o} and Gunnar Gislason and Anne Tj{\o}nneland and Augustin Scalbert and Aed{\'i}n Cassidy and Piccini, {Jonathan P} and Kim Overvad and Hodgson, {Jonathan M} and Frederik Dalgaard",

year = "2020",

month = dec,

doi = "10.1016/j.clnu.2020.04.025",

language = "English",

volume = "39",

pages = "3821--3828",

journal = "Clinical Nutrition",

issn = "0261-5614",

publisher = "Elsevier",

number = "12",

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TY - JOUR

T1 - Flavonoid intake and its association with atrial fibrillation

AU - Bondonno, Nicola P

AU - Murray, Kevin

AU - Bondonno, Catherine P

AU - Lewis, Joshua R

AU - Croft, Kevin D

AU - Kyrø, Cecilie

AU - Gislason, Gunnar

AU - Tjønneland, Anne

AU - Scalbert, Augustin

AU - Cassidy, Aedín

AU - Piccini, Jonathan P

AU - Overvad, Kim

AU - Hodgson, Jonathan M

AU - Dalgaard, Frederik

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND & AIMS: Primary prevention of atrial fibrillation (AF) through behavioural and dietary modification is a critically important and unmet need. Flavonoids are bioactive dietary compounds with promising cardiovascular health benefits. Our aim was to investigate the association between flavonoid intake and clinically apparent AF.METHODS: Baseline data from 55 613 participants of the Danish Diet, Cancer and Health Study, without AF, recruited between 1993 and 1997, were cross-linked with Danish nationwide registries. Total flavonoid and flavonoid subclass intakes were calculated from validated food frequency questionnaires using the Phenol-Explorer database. Associations between flavonoid intake and incident AF (first-time hospitalization or outpatient visit) were examined using restricted cubic splines based on Cox proportional hazards models.RESULTS: During a median [IQR] follow-up of 21 [18-22] years, 7291 participants were diagnosed with AF. Total flavonoid intake was not statistically significantly associated with risk of incident AF in the whole cohort. However, compared to the lowest quintile, a total flavonoid intake of 1000 mg/day was associated with a lower risk of AF in smokers [0.86 (0.77, 0.96)] but not in non-smokers [0.96 (0.88, 1.06)], and a lower risk of AF in high alcohol consumers [>20 g/d: 0.84 (0.75, 0.95)] but not in low-to-moderate alcohol consumers [<20 g/d: 0.97 (0.89, 1.07)].CONCLUSION: Intake of flavonoids was not significantly associated with a lower risk of incident AF. However, higher intakes of flavonoids may be beneficial for those at a higher risk of developing AF.

AB - BACKGROUND & AIMS: Primary prevention of atrial fibrillation (AF) through behavioural and dietary modification is a critically important and unmet need. Flavonoids are bioactive dietary compounds with promising cardiovascular health benefits. Our aim was to investigate the association between flavonoid intake and clinically apparent AF.METHODS: Baseline data from 55 613 participants of the Danish Diet, Cancer and Health Study, without AF, recruited between 1993 and 1997, were cross-linked with Danish nationwide registries. Total flavonoid and flavonoid subclass intakes were calculated from validated food frequency questionnaires using the Phenol-Explorer database. Associations between flavonoid intake and incident AF (first-time hospitalization or outpatient visit) were examined using restricted cubic splines based on Cox proportional hazards models.RESULTS: During a median [IQR] follow-up of 21 [18-22] years, 7291 participants were diagnosed with AF. Total flavonoid intake was not statistically significantly associated with risk of incident AF in the whole cohort. However, compared to the lowest quintile, a total flavonoid intake of 1000 mg/day was associated with a lower risk of AF in smokers [0.86 (0.77, 0.96)] but not in non-smokers [0.96 (0.88, 1.06)], and a lower risk of AF in high alcohol consumers [>20 g/d: 0.84 (0.75, 0.95)] but not in low-to-moderate alcohol consumers [<20 g/d: 0.97 (0.89, 1.07)].CONCLUSION: Intake of flavonoids was not significantly associated with a lower risk of incident AF. However, higher intakes of flavonoids may be beneficial for those at a higher risk of developing AF.

KW - Atrial fibrillation

KW - Cardiovascular disease

KW - Flavonoids

KW - Nutrition

KW - Primary prevention

KW - Prospective cohort study

UR - http://www.scopus.com/inward/record.url?scp=85084237148&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2020.04.025

DO - 10.1016/j.clnu.2020.04.025

M3 - Journal article

C2 - 32386860

SN - 0261-5614

VL - 39

SP - 3821

EP - 3828

JO - Clinical Nutrition

JF - Clinical Nutrition

IS - 12

ER -

Flavonoid intake and its association with atrial fibrillation

Abstract

Keywords

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